Sec Form 4 Filing - DAVIS ALISON @ Blockchain Coinvestors Acquisition Corp. I - 2021-11-09

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
DAVIS ALISON
2. Issuer Name and Ticker or Trading Symbol
Blockchain Coinvestors Acquisition Corp. I [ BCSA]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Managing Director
(Last) (First) (Middle)
P.O. BOX 1093, BOUNDRY HALL, CRICKET SQUARE
3. Date of Earliest Transaction (MM/DD/YY)
11/09/2021
(Street)
GRAND CAYMAN, E9KY1-1102
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Class A Ordinary Shares 1,322,000( 1 ) I By Blockchain Coinvestors Acquisition Sponsors I LLC( 2 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Class B Ordinary Shares ( 3 ) 11/09/2021 D 5,000( 4 ) ( 3 ) ( 3 ) Class A Ordinary Shares 5,000 $ 0 9,850,000( 5 ) I By Blockchain Coinvestors Acquisition Sponsors I LLC( 2 )
Warrants (right to buy) $ 11.5 ( 6 ) ( 7 ) Class A Ordinary Shares 661,000 661,000( 8 ) I By Blockchain Coinvestors Acquisition Sponsors I LLC( 2 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
DAVIS ALISON
P.O. BOX 1093, BOUNDRY HALL
CRICKET SQUARE
GRAND CAYMAN, E9KY1-1102
X Managing Director
Signatures
/s/ Alison Davis 03/07/2022
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Adjusted to show the reduction by 300 in the number of shares underlying the units of the issuer previously reported on Form 3A filed on March 7, 2022 to reflect the partial exercise by the underwriters of the issuer's initial public offering of their over-allotment option.
( 2 )As a manager of the Blockchain Coinvestors Acquisition Sponsors I LLC (the "Sponsor"), the reporting person may be deemed to share beneficial ownership of the securities held by the Sponsor. The reporting person disclaims any beneficial ownership of any securities of the issuer held by the Sponsor except to the extent of her ultimate pecuniary interest.
( 3 )The shares of Class B ordinary shares, par value $0.00009 per share, of the issuer will automatically convert into shares of Class A ordinary shares, par value $0.0001 per share, of the issuer upon the consummation of the issuer's initial business combination as described in the issuer's registration statement on Form S-1 (File No. 333-259091) (the "Registration Statement") in the section entitled "Description of Securities-Founders Shares." The shares of Class B ordinary shares have no expiration date.
( 4 )These shares represent Class B ordinary shares held by the Sponsor. The Sponsor forfeited 5,000 shares of Class B ordinary shares to the issuer for no consideration, which was exempted pursuant to Rule 16b-3(e) under the Securities Exchange Act of 1934, as amended, in connection with the underwriters' election not to exercise their over-allotment option in full.
( 5 )Reflects the adjustment of the number of shares of Class B ordinary shares previously reported on Form 3 filed on November 9, 2021 for the subsequent stock split and stock dividend with respect to the Class B ordinary shares effective November 9, 2021.
( 6 )The warrants will become exercisable at the later of 30 days after the consummation of the issuer's initial business combination or 12 months from the completion of the issuer's initial public offering.
( 7 )The warrants will expire five years after the consummation of the issuer's initial business combination or earlier upon redemption of all of the issuer's outstanding common stock or the issuer's liquidation.
( 8 )Adjusted to show the reduction by 150 in the number of warrants underlying the units of the issuer representing the right to purchase shares of Class A ordinary shares previously reported on Form 3A filed on March 7, 2022 to reflect the partial exercise by the underwriters of the issuer's initial public offering of their over-allotment option.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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